Abstract

REY DE CASTRO MUJICA, Jorge; ROSALES MAYOR, Edmundo  and  FERREYRA PEREYRA, Jenny. Evaluation of the relationship between obstructive sleep apnea (OSA) and hypertension (HP).. Rev Med Hered [online]. 2009, vol.20, n.3, pp.123-132. ISSN 1018-130X.

Objective: To evaluate the relation between Obstructive Sleep Apnea (OSA) and hypertension (HP). Material and methods: Clinical population-based study in 367 patients with suspected breathing sleep disorder. A complete clinical history and polysomnography (PSG) or respiratory polygraphy (RP) were done. Eighty-five patients were excluded. We did summary measures, median difference analysis, relations between variables, univariate and multivariate logistic regression. Results: Age 49.6 ± 12.7 (18-90) years, 247 patients (84%) males, body mass index (BMI) 29.6 ± 4.7 (20.1-47.6) kg/m2. HP rate was 67%. We made 229 (78%) PSGs and 65 (22%) RPs. Apnea-Hipopnea Index (AHI) 34.8 ± 27.4 (0-125), Maximum Oxygen Desaturation (MaxDesat) 81.5 ± 9.5 (38-95) % and percentage of registry time with SatO2 below 90% (T90) 8.8 ± 15.2 (0-72) %. The main diagnoses were: OSA 253 (86%), primary snoring 34 (12%) and without breathing sleep disorder 7 (2%). From OSA patients, 45 (18%) were mild (AHI 5 to <15), 57 (22%) moderate (AHI 15 to <30) and 151 (60%) severe. We did a univariate logistic regression model of some OSA variables in relation to HP. When analyzing AHI we obtained OR 1.029 (CI 95% 1.017-1.041 p<0.001), with MaxDesat OR 1.072 (CI 95% 1.037-1.109 p<0.001) and T90 OR 1.062 (CI 95% 1.029-1.095 p<0.001). When we introduced to the model age, sex and BMI; the AHI adjusted OR was 1.205 (CI95% 1.064 - 1.363 p=0.003), DesatMax adjusted OR 1.693 (CI95% 1.208 - 2.374 p=0.002) and T90 adjusted OR 1.517 (CI95% 1.163 - 1.979 p=0.002). Conclusions: We concluded that OSA is associated to HP independently of age, sex and BMI. It is required to make studies with greater sample to evaluate the effect of other variables in this association. (Rev Med Hered 2009;20:123-132).

Keywords : obstructive sleep apnea; hypertension; polysomnography; respiratory polygraph; primary snoring.

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